Individual
MATTHEW GERDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 BRADBURY LN, SPARTA, IL 62286-2102
(618) 443-3088
Mailing address
4156 WATER OAK LN, SMITHTON, IL 62285-3666
(618) 670-0561
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
0000935841
IL
146L00000X
Paramedic
P-16058
MO
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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